Brutus

Brutus presented at the beginning of January, with a history of having had an episode of vomiting and having breathing difficulties. When he came in he had increased respiratory noise, coming from his upper airway and increase respiratory effort.
We assessed his chest and concluded that when he had vomited Brutus had aspirated some of his vomit, and some of the other vomit had gone up behind his soft palate and that he had some minor swelling in his tongue and soft palate which was making breathing harder than usual.
We treated Brutus with broad spectrum antibiotics and medications to help reduce the secondary swelling in his airways. Next day when we touched base with his owners they reported that he had initially improved but now seemed worse, not wanting to lie down.
We rechecked Brutus, his breathing had worsened, his tongue was more swollen, and he was having increasing difficulty getting air. Initially we repeated the medications that had worked the day before and placed him in an oxygen cage. When this was not improving his condition we anesthetized Brutus and placed an endo-tracheal tube, so that his airway was open and he could breathe easily. After another round of medication, we allowed Brutus to regain consciousness, an initial improvement was not sustained and the decision was made, with his owners, to perform an emergency tracheotomy and ship Brutus to a Critical Care hospital in the Lower Mainland for further care.

While we were preparing Brutus for his surgery, Dr Alan Kuzma, from Canada West Veterinary Specialists, called our hospital, having heard from the Critical Care Department what was happening to Brutus. He suggested an alternative course of action, performing a semi- permanent tracheostomy, which would avoid the need for referral and provide Brutus with an immediate stable airway.
Dr Kuzma discussed his surgical technique with Dr Nicol, and how it differed from the standard approach in the text-books. Having run through the surgery with Dr Kuzma, Dr Nicol performed the semi-permanent tracheostomy procedure on Brutus.
Immediately on recovery Brutus was breathing much better and over the next few days the swelling in his tongue and palate and his aspiration pneumonia resolved.
Bulldogs almost all have a condition called brachiocephalic airway syndrome. Their narrow nostrils, long soft palates, redundant laryngeal tissue and narrow tracheas predispose them to airway crises, like the one Brutus had suffered, and often the problems get worse as they age. Now that he was stable, we had Dr Bhandal, our visiting surgeon assess Brutus, and Dr Bhandal performed surgery to open up Brutus’ nostrils, shorten his soft palate and remove the redundant tissue from his laryngeal saccules.
Brutus did well with this surgery and recovered well. The last phase of Brutus journey was to have his tracheostomy closed. Dr Nicol performed the tracheostomy closure and Brutus went home the next day, after spending the best part of three weeks in our hospital.

One of the unexpected results of the final surgery was the obvious joy Brutus felt at having his sense of smell restored. When he had the tracheostomy, he was not able to pull air in through his nose so he had a very limited ability to perceive smell. After his surgery he spent the whole day sniffing and snuffling at everything he could, drinking in the smells!
Brutus is doing well, his owners comment on how much more energy he has now, and all his legion of friends are pleased to have him back.